Cuvitru Prescription Assistance Programs

Cuvitru: Apply for prescription assistance below

If you are eligible, the programs below can help you afford Cuvitru. Review the information to see if you qualify. The applications are available in Adobe PDF format and should be mailed directly to the provider of the patient assistance program.

If you have any questions, please call the telephone number for the program (not or go to the program website.

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My IG Source Program

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Provided by: Takeda Pharmaceutical
TEL: 855-250-5111
Languages Spoken:
English, Others By Translation Service
Program Website
Program Applications and Forms
  • Cuvitru (immune globulin subcutaneous (human))
Eligibility Requirements
  • Insurance Status Contact program for details.
  • Those with Part D Elibible? No
  • Income Not disclosed
  • Diagnosis/Medical Criteria FDA-approved diagnosis
  • U.S. Residency Required? The patient must be a US citizen or legal resident.
  • Obtaining Call for prescreening
  • Receiving Varies
  • Returning The completed application must be faxed back.
  • Doctor's Action Varies
  • Applicant's Action Call for information or inform doctor that he/she is in need
  • Decision Communicated Patient and Doctor are notified
  • Decision Timeframe Not specified
  • Amount/Supply Not specified
  • Sent To Not specified
  • Delivery Time Not specified
  • Refill Proces Not specified
  • Limit Not specified
  • Re-application Contact program for details.
Additional Information
Eligibility determined on a case-by-case basis. This program also provides copay assistance.
Updated August 5, 2019

If you, your patient or loved one does not qualify for this program or other prescription savings programs, then please search for prices here.

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